Skin Necrosis w/ Dermal Filler - How Rare is It?

I cannot find the overall statistics for the chance of skin necrosis while receiving a dermal filler. I know this is "rare", that is all I hear, but HOW RARE? Does anyone have overall statistics? Also WHY is this so rare to happen? (also very concerned it will be injected into blood vessel resulting in a heart attack, etc...WHY is this rare and how rare?

Doctor Answers 1

Skin necrosis with dermal filler

January 28th, 2011

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The necrosis is due to direct injection into an artery or compression of an artery by the filler preventing blood flow. This is the only reference I could find "The most serious side effect is localized tissue necrosis, which is induced by mechanical interruption of local vascularity, though it occurs very rarely (nine in 10,000 patients who underwent collagen implantation)". This was a review of collagen fillers done some years ago. When injected with proper technique the incidence should be zero. Certain areas like the area between the eyebrows are at higher risk because of the architectural layout of the blood vessels under the skin. The incidence of heart attack from injection of a skin filler should be close to zero.

The most import thing besides proper injection technique is that if you experience inappropriate pain after filler injection and/or see significant skin discoloration beyond a little bruising your doctor needs to go into emergency mode. That could involve application of nitropaste to the skin surface, application of warmth, injection of a filler dissovling agent, hyperbaric oxygen etc. All of these modalities will minimize the amount of skin necrosis.

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